Comprehensive Evaluation of Pulmonary Lesions in Pediatric COVID-19: Insights from Chest CT Scans

Background: COVID-19 manifestations in children range from mild to severe. Identifying characteristic chest computed tomography (CT) features in this age group is crucial for accurate diagnosis and effective screening. This study aimed to explore CT imaging patterns in pediatric COVID-19 cases to enhance diagnostic methods. Methods: This cross-sectional, retrospective study examined chest CT scans of 42 children with confirmed COVID-19 at Taleghani Hospital, Gorgan, Iran (2021-2022). Data were collected using a comprehensive 14-item checklist covering demographics, extent of lung involvement, and various radiological features. Descriptive statistics and Fisher's exact test were employed for data analysis. Results: Ground-glass opacities (GGO) were the most prevalent finding, present in 92.9% of cases, followed by consolidation in 54.8%. These abnormalities predominantly affected the peripheral lung zones (45.24%) or both central and peripheral zones (40.48%). Notably, 7.1% of children exhibited no visible pulmonary lesions. The lower lobes, particularly the left and right lower lobes, were most frequently involved. Pleural effusion was observed in 4.8% of cases, while pericardial effusion and mediastinal lymphadenopathy were absent. The greatest extent of involvement was noted in the lower lung zones, with approximately one-third of children showing involvement of three lung lobes. Conclusion: This study reveals prevalent radiological features of pediatric COVID-19, including GGO, consolidation, and peripheral lung lesions. The rarity of certain findings contrasts with adult cases, potentially informing future diagnostic approaches and clinical management strategies for pediatric COVID-19 patients, and potentially aid in developing AI-based tools for interpreting pediatric COVID-19 chest CT scans.